Management of missing anterior teeth can pose significant challenges for the orthodontist, as the maxillary incisors are key to esthetic orthodontic treatment planning. Two treatment modalities for patients that are unilaterally missing a maxillary lateral incisor that offer definitive functional and esthetic natural-tooth replacements for patients, regardless of age, are orthodontic canine substitution (OCS) and autotransplantation (AT) of a lower incisor. Using validated indices and an electronic questionnaire, the purpose of the study was to assess, objectively and subjectively, whether AT of a lower incisor or unilateral OCS offers patients who present with a unilateral missing maxillary lateral incisor a better esthetic result. An orthodontist, periodontist, restorative dentist, and prosthodontist evaluated intraoral frontal images of 55 patients who were missing a single maxillary lateral incisor and were treated with unilateral OCS (25) or AT of a lower incisor (30) using the Pink and White Esthetic Indices. In addition, the specialists evaluated 30 finished orthodontic cases with no missing teeth as controls. An electronic survey was distributed to orthodontists, general dentists, and laypeople to gauge subjective opinions on the esthetic results of OCS versus AT. Lower incisor autotransplantation and unilateral orthodontic canine substitution had statistically significant lower esthetic scores than cases without missing teeth. The scores of AT and OCS were not significantly different from one another. Electronic survey data showed that dental providers find finished orthodontic cases the most esthetic, followed by lower incisor AT and unilateral OCS. Laypeople find unilateral OCS significantly more esthetic than both control and AT cases. Compared to unilateral OCS, lower incisor AT offers comparable esthetic outcomes and should be considered in cases of unilateral missing maxillary lateral incisors. This study demonstrated that orthodontic space closure and dental autotransplantation can be acceptable treatment solutions for growing patients with a unilateral missing maxillary lateral incisor. Esthetic outcomes in the maxillary anterior region can impact the psychological status of a patient during an important developmental stage.

The authors aimed to evaluate dentists' knowledge of, diagnostic confidence in, perception of, and clinical management for molar incisor hypomineralization (MIH) across countries with varying income levels and identify predictors of MIH familiarity. A cross-sectional online survey was distributed from February 2024 through July 2025 to general dentists, pediatric dentists, and endodontists in 19 countries representing all World Bank income groups. A validated questionnaire assessed demographic characteristics, MIH knowledge using an 85-point scale, diagnostic confidence, perceptions, and management. Data were analyzed using χ2 and Mann-Whitney U tests and generalized linear models. A total of 4,056 dentists participated. Familiarity and diagnostic confidence increased with country income level (P < .001) and were highest among pediatric dentists (P < .001). Knowledge scores varied; they were higher among dentists from higher-income countries, women, pediatric dentists, and those aged 31 through 40 years, with 5 or more years of experience, working in public settings, and holding advanced degrees (all, P < .001). Enamel hypoplasia was the common diagnostic challenge, and fewer than one-half reported using established MIH criteria. Preventive and minimally invasive strategies were frequent in high- and upper-middle-income countries, whereas low- and lower-middle-income dentists relied on basic restorative materials and extensive tissue removal. Pulpal therapy followed standard protocols, although conservative vital pulpal therapy was common in upper-middle-income settings. Respondents from high-income countries cited technical failures often, and those from low-income countries reported greater behavioral barriers. Regression analysis confirmed income level, specialty, and experience as predictors of familiarity and confidence. Substantial global disparities exist in MIH knowledge, diagnostic confidence, and clinical management strategies. Improved training and resource-appropriate guidelines are essential to reduce inequities in MIH care. The authors highlight the need for targeted training and context-specific guidelines to improve MIH diagnosis, confidence, and management, particularly in low-income settings.

Oxidative stress, collagen synthesis, and inflammatory processes have a role in orthodontic movement of teeth. Vitamins C and E play supportive roles, but awareness among dental professionals might not be sufficient. This article aims to compare awareness of the role of vitamins C and E in orthodontic preventive care among Iraqi dental students and practitioners. This article aims to compare awareness of the role of vitamins C and E in orthodontic preventive care among Iraqi dental students and practitioners. A cross-sectional survey was conducted among a sample population of 490 respondents (234 undergraduates, 146 general and non-orthodontic practitioners, and 110 orthodontic practitioners). The survey questions covered the topics of awareness, behavior, perception, and attitudes. Data were analyzed using Chi-square and Kruskal-Wallis tests, with the level of statistical significance set at p = 0.05. The level of awareness was greatest in orthodontic practitioners (58.2%), followed by undergraduates (42.3%) and general practitioners (28.8%). Use of nutritional supplements was also not very common, and intake of vitamin C-rich foods was more often than vitamin E-rich foods. The most preferred method for vitamin administration was systemic supplementation; however, the lack of strong evidence remained the main concern regarding the administration of vitamins C and E. The attitudes of all groups were positive toward the incorporation of nutritional adjuncts in patient care and education. Orthodontic practitioners were the most aware of vitamins C and E in prevention care in orthodontics; students, general, and non-orthodontic dentists had significant gaps in their knowledge. Although there were positive attitudes toward the use of nutrition in education and patient care, there was limited use of supplements, and more robust evidence and improvement of the curriculum is necessary.

Individuals with intellectual and learning disabilities (ILD) face significant barriers to dental care and experience disproportionately poor oral health outcomes. Evidence on dentists' preparedness, confidence, and stress in providing care for this population across public hospital settings in Thailand remains limited. A cross-sectional survey was conducted among 306 dentists in public-sector hospitals across 17 provinces of Northern Thailand (November 2024 to May 2025). A validated online questionnaire assessed individual-, institutional-, and system-level preparedness factors. Chi-square tests compared hospital settings, and multivariable binary logistic regression identified independent predictors of high confidence and high stress. Most respondents (80.72%) had experience treating patients with ILD, though 65.69% treated fewer than ten patients per year. The main challenges were communication difficulties (86.93%) and behavioural management difficulties (83.66%). High or very high stress was reported by 53.26%, and 15.69% reported stress reduced care quality. Access to specialist referral and facility readiness were significantly lower in community hospitals (p < 0.001 and p = 0.003). Overall, 92.48% perceived undergraduate training as insufficient. In the multivariable analysis, adequate personnel and equipment was the only independent predictor of high confidence (OR = 2.739, 95% CI: 1.390-5.396, p = 0.004). High stress was independently associated with more than ten years of clinical experience (OR = 2.325, 95% CI: 1.272-4.251, p = 0.006), postgraduate education (OR = 1.926, 95% CI: 1.030-3.602, p = 0.040), and being a general dentist rather than a specialist (OR = 0.285, 95% CI: 0.146-0.555, p < 0.001). Dentists' preparedness is shaped by individual, institutional, and system-level factors. Adequate personnel and equipment was the key predictor of confidence, while stress was linked to clinical experience, postgraduate education, and professional role. Strengthening education, workplace resources, and referral support may improve preparedness and access to dental care for patients with ILD.

There is a worldwide movement toward competency-based medical education to equip dental students with essential competencies required to meet health care needs. In Syria, dental faculties currently lack a formal competency-based curriculum for endodontics at the undergraduate level. Moreover, the quality of root canal treatment performed by general dentists is frequently described as inadequate or substandard. This study aimed to develop a national consensus on the required competencies for undergraduate endodontics in Syria in order to establish a foundation for a standardized national curriculum, which can guide educators in adopting best practices in both dental education and clinical endodontics. This study was conducted at Syrian Virtual University between April and June 2025. A modified Delphi technique was used to determine endodontic competencies. Initially, a group of 5 Syrian endodontic consultants identified preliminary competencies. In the first round, 53 experts evaluated these competencies by using a 5-point Likert scale. Based on these results, a second round was conducted with 38 experts. Competencies with a weighted average above 4.20 were considered essential. Data analysis was performed using IBM SPSS package 27, and survey reliability was measured by Cronbach α. Following the final Delphi round, a set of 31 competencies was established, comprising 9 knowledge, 13 skills, and 9 attitudes competencies. Cronbach α was more than 0.9 in the first and second round. The standard deviation across all questionnaires was low (≤0.85). The standard error was also minimal (≤0.12). This study identified a set of core endodontic competencies for the undergraduate level in Syria. These competencies are intended to support students in acquiring the required knowledge, skills, and attitudes, and assisting policymakers in implementing competency-based medical education within Syria and similar contexts.

Dental tourism is a growing trend involving patients traveling across borders for dental treatment. While dental tourism may benefit some patients, it also poses considerable risks. However, the dental tourism trends have not been explored in Saudi Arabia. The aim of the study was to investigate the perspectives of dental professionals about dental tourism in the Eastern Province of Saudi Arabia. A cross-sectional questionnaire-based study was conducted among dental professionals in the Eastern Province of Saudi Arabia. The study included male and female dental professionals (general dentists, specialists, and consultants) working in the private and public sectors in Dammam, Al Khobar, Al Jubail, and Al Ahsa. A convenience sampling technique was used to recruit the participants. The researchers visited clinics and hospitals and provided a self-administered questionnaire to participating dentists. The questionnaire included demographic information and questions related to encountering dental tourists, reasons for getting treatment abroad, problems related to treatment, and views about dental tourism. SPSS (Version 22.0) was used for statistical analyses and a p-value < 0.05 was considered statistically significant. The study included data from 326 dentists, with 62.9% of males and 37.1% of females. The majority of the participants (97.5%) reported that they encountered dental tourists in their dental practice. Multiple logistic regression showed that general practitioners were significantly less likely to encounter dental tourists compared to specialists/consultants (OR=0.08, P= 0.022). Affordable treatment (95.1%) was the most common reason for getting dental treatment abroad. Lack of treatment planning (73.6%), lack of availability of practitioner post treatment (66.6%), and lack of follow up maintenance (59.5%) were the most common problems related to dental treatment received abroad. The majority of patients received dental treatment in Egypt (71.8%), Turkey (69.6%), and GCC countries (50%). The veneers (81.9%), crowns (78.5%), and bridges (76.1%) were the most common dental treatments received abroad. The dentists reported that dental tourism could endanger patients' dental health (58.9%), but it enhanced their professional experience (43.6%) and understanding of dental treatment provided in other countries (41.4%). The study concluded that dental tourism was very common in the Eastern Province of Saudi Arabia. Specialists and consultants were more likely to encounter dental tourists compared with general practitioners. Affordability of dental treatment was the most common reason for dental tourism. The veneers, crowns, and bridges were the most frequently received dental treatments abroad. Most dentists reported that dental tourism could compromise oral health of patients.

People with disabilities may experience challenges in access to oral health care. The authors examined differences in dental care provider mix (ie, type of dental care providers visited) and dental service mix (ie, types of dental services) between working-aged adults with and without disabilities. The authors analyzed data from the 2021-2022 Medical Expenditure Panel Survey. The sample included 10,397 adults aged 18 through 64 years who reported at least 1 dental visit in the past year. Disability status was determined from participants' responses to questions on physical, hearing, vision, or cognitive limitations. The authors estimated the rates of visiting 3 types of dental care providers (ie, general dentist, dental hygienist, and dental care specialists) and use of dental services, grouped into preventive dental procedures and treatment procedures, including restorative and endodontic, periodontic, oral surgery, prosthetic, and orthodontic. Weighted multiple logistic regression was used to estimate the association between disability status, dental service use, and dental care provider type. Adults with disabilities were less likely to undergo preventive dental procedures (adjusted odds ratio [AOR], 0.62; 95% CI, 0.52 to 0.74) and more likely to undergo treatment procedures (AOR, 1.45; 95% CI, 1.23 to 1.69) than those without disabilities. They were less likely to have visited a dental hygienist (AOR, 0.79; 95% CI, 0.65 to 0.95). According to the 2021-2022 Medical Expenditure Panel Survey data, adults with disabilities who visited a dentist were less likely to receive preventive care and more likely to undergo treatment, suggesting that oral health problems may have necessitated the dental visit. Interventions should be tailored to disability-related needs, improve preventive dental service use, and include expanded dental insurance coverage to reduce cost barriers.

Most cleft teams in The Netherlands have a paediatric dentist as a permanent team member, but differences persist in patients receiving general or specialised dental care in-between team visits. The current study aims to find out if different strategies regarding dental care result in different caries experience and restorative care levels of cleft lip and/or palate (CL/P) patients. The cleft team of the Amsterdam University Medical Center, presented as Team Spec, refers all CL/P patients at age one to specialised dental care. The majority of CL/P patients treated in theErasmus Medical Center, Rotterdam, receive dental care from a general dentist, Team Gen. Data on decayed teeth (dt), missing teeth (mt), filled teeth (ft), sum dmft and restorative care level for the primary dentition of CL/P patients were compared with independent t-tests. Negative binomial hurdle regression and generalised linear models were used to correct for age, gender and cleft type. No comparison of the costs of both strategies was made. The restorative care level of Team Spec (51.50%) was significantly better than Team Gen (29.31%) (p < 0.001). Though sum dmft of both teams was comparable (p = 0.32), patients in Team Spec had fewer missing teeth due to caries (p = 0.01). Receiving specialised dental care is beneficial for the restorative care level of CL/P patients.

Background: Inappropriate antibiotic prescribing in dentistry contributes significantly to global antibiotic resistance. Clinical guidelines published by the American association of endodontists (AAE) explicitly state thatclinicians should avoid prescribing antibiotics for uncomplicated dentoalveolar infections unless systemic symptoms are present. Evaluation of compliance with current antibiotic prescribing guidelines and identifying the gaps between knowledge and clinical performance of clinical practitioners is essential.Purpose: This study was conducted to assess the knowledge and clinical performance regarding antibiotic use in endodontic treatments among general dentists in Shiraz, Iran, regarding the latest AAE guidelines.Materials and Method: A cross-sectional study was conducted using a validated questionnaire (Content Validity Index= 0.89, Cronbach’s α= 0.82) distributed to 140 general dentists and residents in Shiraz via random sampling.The questionnaire assessed (1) demographic characteristics, (2) knowledge of current guidelines, and (3) clinical prescribing performance through case scenarios. We analyzed data from 103 completedresponses using IBM SPSS v27.0 (IBM Corp., Armonk, NY, USA) with descriptive statistics, chi-square tests, and binary logistic regression (p Value < 0.05).Results: While participants demonstrated moderate to good theoretical knowledge (70.9% correctly identified first-line antibiotics), significant gaps existed in clinical application. Notably, 69.9% ofparticipants prescribed antibiotics inappropriately for immunocompromised patients. Residents exhibited significantly better practical guideline compliance than general practitioners (p= 0.019).No significant associations were found with gender, clinical experience, or workplace. Also, 88.3% expressed need for further training. Conclusion: Considering moderate to good knowledge, coupled with a low to moderate performance level, significant deviations from AAE guidelines highlight the need for targeted educational interventions, including workshops and curriculum integration, to improve antibiotic stewardship.

Background/Objectives: Dentists, due to their close contact with patients, are in a unique position to recognize and report cases of child abuse and neglect. This study aimed to explore dentists' knowledge and attitudes toward child abuse and neglect encountered in their professional practice. Methods: An anonymous questionnaire survey was conducted among 414 members of the Lithuanian Dental Chamber (general dentists, dental specialists, dental hygienists, and dental assistants) and 153 graduating dental students, yielding a total sample of 567 respondents. They reported knowledge and attitudes regarding reasons for child abuse within the family and barriers to referring suspected cases. The underlying structure of responses was examined using exploratory factor analysis, and differences in knowledge and attitudes across professional groups were tested using ANOVA. Results: Most respondents agreed that low family socioeconomic status (87.7%), child's disability (65.3%), and medical conditions (53.2%) are the main reasons for child abuse. These and other reasons clustered into two factors: family social vulnerability, and child health-related vulnerability; however, professional specialization had only a very small effect on both factors (η2 = 0.013 and η2 = 0.017, respectively). The majority of respondents (75.6%) agreed that dentists should report cases of child abuse or violence against children in all circumstances. The barriers to reporting child abuse were fear of negative consequences, and professional uncertainty; professional specialization had a significant effect on both of these factors (η2 = 0.019, p = 0.027 and η2 = 0.037, p < 0.001, respectively). Dental specialists reported the highest levels of fear of negative consequences and professional uncertainty, whereas students reported the fewest difficulties in reporting. Dental specialists and students demonstrated the highest levels of knowledge, while dental hygienists demonstrated the lowest level of knowledge regarding child abuse (mean sum score of knowledge was 11.2 (SE 0.38) vs. 10.0 (SE 0.30), respectively, p = 0.014). Conclusions: Overall, Lithuanian dentists, including students, demonstrate moderate knowledge and attitude in recognizing cases of child abuse and neglect; however, differences across professional groups remain and should be addressed to ensure more effective child protection.

Accurate periodontal diagnosis is the cornerstone of effective treatment planning and disease management; however, the clinical application of diagnostic criteria often remains inconsistent. Despite the availability of established international guidelines, dental professionals frequently encounter difficulties in clinical judgment, radiographic assessment and the interpretation of diagnostic parameters. Understanding global patterns of these diagnostic errors across regions and professional groups is crucial for identifying gaps in dental education and improving evidence-based periodontal care worldwide. The aim of the study was to develop a 5-item questionnaire assessing basic periodontal knowledge among dentists, dental students, dental hygienists, and specialists in periodontics worldwide, as well as to understand global patterns and clinical standards. A total of 3,328 professionals from over 60 countries were invited to participate in the questionnaire between September 1 and October 23, 2025. The invitees received e-mails with a link to access the survey. The questions were developed to assess basic periodontal knowledge, such as diagnostic parameters in periodontology, probing and its significance, evidence-based questions, and radiographic assessment. The data was weighted and statistically analyzed. A total of 543 participants from 46 countries completed the questionnaire (response rate: 16.32%), comprising 266 specialists in periodontics/dental hygienists (S-DHs) and 277 dentists/dental students (D-Ds). Overall, the first group demonstrated superior performance across most questions. The error rates varied markedly across continents. Despite this geographic variation, continents displayed similar internal patterns of errors, as shown by positive intercontinental correlations across most questions. Conversely, question 3 - addressing the balance between clinical judgment and evidence-based guidelines - demonstrated weak or negative correlations with the remaining items, behaving as an independent construct. The observed patterns demonstrated that diagnostic errors cluster within a largely cohesive technical domain, while judgment-based decision-making forms a distinct dimension of performance. This global analysis revealed substantial differences in periodontal diagnostic performance across continents, countries and professional groups. However, the errors followed a consistent and structured pattern. Specialists and dental hygienists outperformed general dentists and students, especially in the more interpretive questions. The findings suggest that improving periodontal diagnostic accuracy worldwide will require coordinated efforts to strengthen technical calibration and promote consistent use of modern diagnostic guidelines, especially in lower-performing regions.

Static computer-assisted guided implant placement (sCAIP) has been shown to enhance accuracy and predictability; however, little is known about the multifactorial decision-making processes impacting use among clinicians. An exploratory cross-sectional electronic survey was distributed to implant practitioners across Australia and New Zealand, including general dentists and specialists (periodontists, prosthodontists, oral surgeons, and oral and maxillofacial surgeons) involved in implant placement. Items covered demographics, training profiles, clinical experience, utilisation patterns, and attitudes towards sCAIP, with free-text reflections. Quantitative data were analysed using descriptive statistics, factor analysis, and t-tests; qualitative data underwent thematic analysis. Thirty-three respondents completed the survey, with 90.9% reporting current use of sCAIP. Sixteen respondents (48.5%) were classified as analytical decision-makers and 17 (51.5%) as intuitive. Factor analysis identified seven components that explained 84.2% of the variance in decision-making, including surgical complexity and soft tissue conditions, case timing, aesthetic site sensitivity, cost, anatomical risk, training exposure, and clinical experience. Internal consistency across items was high (Cronbach's alpha, α = 0.95). Analytical decision-makers placed significantly more weight on anatomical risk and bone quality compared to intuitive decision-makers (p = 0.038, d = 0.93). Intuitive decision-makers reported higher levels of training exposure (p = 0.04, d = 0.80). Thematic analysis revealed three key influences on sCAIP use: clinician capability, surgical planning and risk mitigation, and restorative outcomes. In addition, several barriers were identified including financial cost, workflow integration, and attitudinal factors. Clinicians with an analytical decision-making style placed greater emphasis on anatomical risk and were more likely to adopt sCAIP in complex or high-risk cases. Because intuitive clinicians reported higher training exposure, education alone did not explain these patterns, indicating that cognitive style and risk appraisal are central determinants of sCAIP adoption.

Mixed reality (MR), encompassing augmented reality (AR) and virtual reality (VR) technologies, is an emerging tool in clinical dentistry that enables digital information to be displayed directly within the clinician’s field of view. Modern dental practice relies heavily on electronic health records, radiographic imaging, and computer-assisted diagnostic and surgical systems, often requiring clinicians to divert attention away from the operative field. These interruptions can disrupt workflow and increase cognitive load. This study aimed to quantify computer dependence across common general dentistry and oral surgery procedures and to evaluate which clinical discipline may benefit most from MR integration into dental loupes. A retrospective observational analysis was conducted on fifty patients treated by a single general dentist, with ten patients included in each procedure category: Extraction(s), Root Canal Treatment(s), Crown(s), Filling(s), and Prophylaxis. An additional fifty patients were treated by two oral surgeons across six procedure categories, with ten patients per category except for implant procedures, which included five patients each: Surgical Extraction(s) with IV Sedation, Implant without Assisted Reality Glasses, Implant with Assisted Reality Glasses, Bone Graft with IV Sedation, Bone Graft with Local Anesthesia, and Biopsy. Computer usage was quantified as seconds per interaction with digital devices during active treatment. A two-sample t-test demonstrated a statistically significant difference in computer usage between general dentistry and oral surgery procedures (p &lt; 0.001), with oral surgery exhibiting more frequent digital interactions and greater computer dependence. One-way ANOVA tests conducted independently within each discipline revealed significant variation in computer usage among procedure types. These findings suggest that targeted MR integration may be particularly beneficial in oral surgery workflows, where frequent consultation of digital systems is essential. Prioritizing MR and assisted reality technologies in high-dependence procedures may reduce attention shifts, lower cognitive load, and enhance clinical efficiency.

Artificial intelligence (AI) is leading to a significant paradigm shift in medical imaging and diagnostic sciences. In particular, Chat Generative Pre-trained Transformer (ChatGPT) is finding increasing application in diagnostic processes due to its ability to generate clinical outcomes. This study aims to evaluate the diagnostic accuracy of ChatGPT for jawbone lesions and also to compare it with that of Oral and Maxillofacial Radiologists (OMFR), Oral and Maxillofacial Surgeons (OMFS), and general dentists. Thirty cases with jawbone lesions, for which clinical information, panoramic radiographs, and histopathological diagnoses were available, were selected. A questionnaire was prepared, including participants' (OMFR, OMFS, and general dentists) demographic information, the cases' clinical findings and panoramic radiographs, and distributed via electronic communication channels. The same cases were loaded into ChatGPT-4 and asked to generate a preliminary diagnosis. The data were statistically analyzed using the Wilcoxon Signed Rank, Mann-Whitney U, and Kruskal-Wallis tests at a significance level of p < 0.05. Overall, ChatGPT's diagnostic accuracy was limited to 46.67%, while the OMFR (67.71%) and OMFS (58.96%) groups had statistically significantly higher success rates (p < 0.05) than ChatGPT. General dentists (37.85%) had lower or similar diagnostic accuracy compared to ChatGPT in most subgroups (gender, age, workplace, professional experience). ChatGPT demonstrated moderate diagnostic accuracy. While OMFR and OMFS participants had significantly higher accuracy rates than ChatGPT, ChatGPT generally outperformed general dentists. These results indicate that such AI systems cannot replace specialist clinicians but can provide valuable contributions as supportive tools that enhance diagnosis.

This study aimed to identify dentist, patient, and pre-treatment clinical characteristics associated with local anaesthesia failure during non-surgical endodontic treatment. Data were collected from the National Dental Practice-Based Research Network study entitled "Predicting Outcomes of Root Canal Treatment (PREDICT)", which included 1723 patients. Local anaesthesia failure during treatment was defined as patient-reported pain of 3 or greater on a 0-to-10-point scale. Pre-treatment factors included patient demographics, psychosocial constructs, and pre-treatment clinical findings (e.g., abnormal sensitivity to cold, biting, percussion, palpation). Characteristics with p < 0.1 (after adjustment for clustering with generalized estimating equations) were entered into a model to identify independent associations with failed anaesthesia, and odds ratios were calculated to measure the strength of these associations. A total of 16% of patients reported intra-operative local anaesthesia failure. Failure was associated with patient age < 55 years (p = 0.05), dental treatment fear ("some" to "extremely afraid") (p = 0.005), mandibular teeth (p = 0.005), and greater numbers of abnormal pre-treatment diagnostic findings (p = 0.02). Protective factors included having treatment done by an endodontist (p = 0.002), and the patient being non-Hispanic White (p = 0.007). Comparisons of local anaesthetic techniques by dentist type (general dentist vs. endodontist) showed statistically significant differences in the bivariate analysis, but none remained significant after adjustment for clustering of patients within dentist. Local anaesthesia failed in 16% of cases. Pre-treatment fear was the only significant psychosocial predictor of intra-operative pain. Failure was more likely in mandibular teeth and when multiple abnormal tests were present pre-operatively (e.g., cold sensitivity, percussion tenderness). Younger patients reported more pain, and endodontists had lower pain rates than general dentists.

To develop a multi-task deep learning model for the automated quality control of periapical radiographs, integrating identification of technical errors with standardized quality grading. A dataset of 3510 periapical radiographs was curated from two centers for model development and external validation. We developed a multi-task deep learning model to simultaneously perform: (1) multi-label classification of six common technical errors (positioning, processing, exposure, and angulation issues); and (2) hierarchical quality grading according to two established standards: the National Radiological Protection Board (NRPB: Grades 1-3) and the College of General Dentistry (CGDent: Ranks A-B). Model performance was evaluated using ROC-AUC, sensitivity, specificity, precision, accuracy, and F1-score on both internal and external test sets. Furthermore, the model's efficiency gain in daily quality control workflows was quantified. Among five widely-adopted Convolutional Neural Networks (CNNs) and transformer architectures evaluated, EfficientNet was selected as the optimal backbone. The final model identified technical errors with high performance on the external test set (sensitivity: 0.690-0.905; specificity: 0.965-0.995; AUC: 0.842-0.978). For quality grading, it achieved strong results for both trichotomous NRPB grading (sensitivity: 0.835-0.920; specificity: 0.881-0.989; AUC: 0.940-0.960) and binary ranking (sensitivity: 0.835-0.989; specificity: 0.835-0.989; AUC: 0.959).The system demonstrated superior computational efficiency, reducing the cumulative assessment time for a typical daily workload from over 32 minutes (manual review) to approximately 1.1 seconds. Grad-CAM visualizations confirmed the model's focus was aligned with technical errors, supporting clinical interpretability. This multi-task model efficiently automates radiographic quality control by identifying technical errors and assigning quality grades. It offers significant potential to standardize quality assurance and streamline dental workflows.

This study investigated UK general dental practitioners' habits and attitudes toward screening, risk assessment, and diagnosis of periodontal diseases and tooth wear in adult patients during routine examinations. Two primary recruiters, UK-based final year post-graduate students enrolled on the MSc in Aesthetic Dentistry at King's College London distributed a piloted, paper-based, 14-statement questionnaire via secondary recruiters to UK general dentists. The latter participants were based at local dental practices or attending post-graduate courses. The secondary recruiters circulated and collected the questionnaire from the participants on the same day of distribution. Responses were supplied in an anonymised manner, and returned to the primary recruiters, either physically or by the scanning of the responses. Data were analysed using descriptive statistics, Chi-squared, and Fisher's exact tests (Stata v12; significance at p < 0.05). Of 325 questionnaires distributed, 261 were satisfactorily completed, n = 261 (response rate: 80.3%). During an adult patient dental examination, high agreement was reported for periodontal risk assessment, probing, and diagnosis (≥ 88%). For the same appointment type, tooth wear risk assessments and clinical assessments were routinely performed by ≥ 81% of the sample, and 74% recorded tooth wear clinical diagnoses. While 98.5% used the Basic Periodontal Examination (BPE), only 29.8% regularly reported using a tooth wear index. The Basic Erosive Wear Examination (BEWE) was the most used (22.9%), but 4.3 times less frequently than the BPE. Satisfaction with undergraduate training with assessment and diagnosis was 2.9 times higher for periodontal assessment than for tooth wear. Significant differences were observed in the use of indices for periodontal disease versus tooth wear. The findings of this study support the need for clearer guidelines and a universally accepted tooth wear index in general practice, alongside improved satisfaction with UK undergraduate training in tooth wear assessment and diagnosis.

ObjectivesThis study investigates clear aligner treatment (CAT) of adult patients in private dental practice and aims to identify: 1) The awareness of and knowledge about CAT among citizens, 2) how citizens who have received CAT experience the treatment and 3) how general dentists and orthodontists assess CAT.Materials and methodsThe study was based on an observational cross-sectional questionnaire investigation. Two separate online questionnaires were sent out to all private dental clinics in Denmark and to a group of 2000 citizens aged ≥18 years.Results217 citizens and 200 practitioners were included in the analysis. The citizens’ awareness of CAT was poor in general, and younger citizens were more aware of CAT. The citizens most often became aware of CAT through their own dentist or through friends and family. The citizens were in general satisfied with their treatments.The practitioners always/often informed about all parameters possible. The most frequent indication for CAT was cosmetics. The orthodontists more often included a lateral cephalogram in the diagnostics before CAT and more often made changes and more comprehensive changes to the digital treatment plan. The orthodontists were less satisfied with CAT compared to the general dentists.ConclusionsThis study has provided valuable knowledge on the awareness and satisfaction of CAT among the citizens and indicated how practitioners assess CAT of adult patients in private dental practice in Denmark.

To assess current utilization of the Prosthodontic Diagnostic Index (PDI), identify perceived benefits and limitations, and evaluate support for future updates. A survey regarding the use of the PDI was made available through email invitations to 68 US dental school prosthodontic/restorative department chairs (PD), 48 graduate prosthodontic program directors (GP), and 1834 private practice prosthodontists (PP) from the American College of Prosthodontists (ACP) member database. The results of this initial survey were inconclusive due to low response rates. The survey was also administered during the 2024 ACP Annual Session with an improved response rate for educators. Descriptive statistics were used to analyze responses from predoctoral education programs and graduate prosthodontic programs. Responses were received from 43.8% (n = 21) graduate prosthodontic programs (GP) and 35.3% (n = 24) predoctoral programs (PD). The PDI was taught to graduate prosthodontic residents at 100% (n = 21) of the responding programs and at 58% (n = 14) of responding predoctoral programs. In contrast, the response rate for private practice prosthodontists, 2% (n = 43), was too low for statistical analysis. The PDI was used for new patient screening in 76.2% (n = 16) of GP and 41.7% (n = 10) of PD programs. The PDI was valued for enhancing diagnostic consistency (81.0%, n = 17 GP and 83.3%, n = 21 PD) and objective patient screening (90.5%, n = 19 GP and 87.5%, n = 21 PD). Common themes were observed in open-ended questions regarding the limitations of the PDI, including that the system was cumbersome, complicated, time-consuming to use, issues with calibration across all cohorts, and lacked recognition by general dentists and other dental specialists. The majority of respondents agreed that the PDI needs an update (76.2%, n = 16 GP and 66.7%, n = 16 PD), including the development of an ACP-endorsed classification system for implant-based treatment (81.0%, n = 17 GP and 91.7%, n = 22 PD). The PDI is viewed as a beneficial diagnostic and educational tool in academic settings. However, it is complex and has limited alignment with contemporary prosthodontic practice. A revision of the classification system could address current limitations and better support clinical decision-making.

To evaluate the accuracy and consistency of responses generated by artificial intelligence (AI) chatbots in pediatric dentistry, specifically concerning fluoride usage. Descriptive cross-sectional study. Four AI chatbots (ChatGPT, Gemini, Claude, Copilot) and four groups of dental professionals (pediatric dentists, general dentists, pediatric dentistry PhD students, and fifth-year dental students) answered 23 true-false questions based on IAPD, AAPD and EAPD guidelines. Each chatbot was tested 28 times per question in separate sessions. Accuracy was analyzed across four categories: Individual Topical Fluoride Applications, Professional Topical Fluoride Applications, Systemic Fluoride Applications, and Fluorosis. All groups were statistically compared with each other to evaluate differences in response accuracy across AI chatbots and human participant categories. Significant differences were observed in the accuracy of chatbot responses across fluoride application categories (p < 0.05). Claude achieved perfect accuracy in Systemic Fluoride Applications (100%), while the other AI models performed lower-with ChatGPT scoring the lowest (94.3%)-and Gemini showed the highest accuracy in Fluorosis-related questions (76.8%). Among professionals, pediatric dentists (82.3%) consistently had the highest accuracy. Chi-square and Fisher's Exact tests were used to assess differences in response accuracy between groups. A p-value < 0.05 was considered statistically significant. Claude and Gemini demonstrated greater reliability in fluoride-related questions than ChatGPT and Copilot. However, expert oversight remains crucial in pediatric dental care.